Read next

The precise inspiration for a novel can be tough to pinpoint. Yet my latest, Big Brother, derived from a single paralytic moment.

The writer photographed in 2007

At home in London in November 2009, I wrote a column for Standpoint magazine about the rise of America’s “fat pride” movement. While glad to relax our literally narrow definition of attractiveness, I felt queasy about the interest group’s assertion that one could be “healthy at any size”. Though I’d never cited my older brother in journalism before, Greg made an irresistible example of someone whose size was anything but “healthy”. Oh, I’d seen enough low-rent documentaries like Half Ton Man to recognise that, merely pushing 400lb at 5ft 7in, my 55-year-old brother wasn’t breaking any records in the weight department.

Nevertheless, he had untreated, exceptionally high-blood-sugar diabetes, hypertension, and such swelling in his feet that some mornings he couldn’t get his boots on. Not long before, he’d nearly died from congestive heart failure. These lines would soon haunt me: “Every time I talk to my brother, I wonder if it’s for the last time. Planning to see him during an author’s tour in March, I’m counting the days, actively anxious that he won’t still be with us a whole three months from now.” In short order, I’d stop counting those days.

For a few hours after I filed that column, my parents rang from the States. Once again, my brother was in hospital.

Because it had become too awkward for him to fly, the day before Greg had taken Amtrak from his home in North Carolina to visit our parents in Manhattan for Thanksgiving. My mother described how, shuffling 30 metres between the taxi and the elevator in their lobby, he’d had to stop and rest twice. Since my brother collected vices as some people do stamps, he was a lifelong smoker with emphysema, which by then obliged him to drag an oxygen tank behind him wherever he went (he only disconnected it from his nose to light another cigarette). There was only so much paraphernalia he’d been able to drag with him on the train, so that night when he went to sleep, in the living room armchair that he preferred to a proper bed, he didn’t have his sleep apnea machine.

The next morning my parents were unable to rouse their son. He was disoriented and incoherent. Consulting the laminated list of prescriptions and emergency numbers Greg had painstakingly printed and looped around his neck for the train trip – he had learnt to prepare for medical crises – my mother rang his doctor, who urged her to get him to hospital immediately. Sleep apnea, another bane of obesity, can build up poisonous levels of carbon dioxide in the blood, and that’s why he was delirious.

Yet getting Greg to hospital was easier said than done. Once the ambulance crew arrived, they were unable to lift him, and had to call for a second crew to help. As both crews knelt beside that chair to hoist their unconscious, wide-load patient, my mother overheard one paramedic whisper to another, “How does this happen?”

At St Luke’s hospital, a few blocks away on the Upper West Side, Greg was kept sedated, because he hated to be constrained, and whenever he awoke he fought the nurses and tore the tubes out. His condition worsened when he contracted an infection, which the poor circulation and overburdened heart of a man his size made it hard for him to fight.

I was my brother’s designated “health proxy”, meant to take medical decisions on his behalf if he was incapacitated. Thus, eight days after Greg entered the intensive care unit, his doctor rang me in London to say it finally seemed that Greg was out of the woods, and to consult me on what came next. St Luke’s is renowned for its treatment of obese patients, so I asked if my brother was a candidate for bariatric surgery. Yes, the doctor said, he would be well-suited for a gastric bypass, and the hospital would be willing to do the operation and undertake the protracted follow-up treatment. But there was a caveat: Greg would need someone to take care of him, and he would need somewhere to live in the New York area.

Standing in my London kitchen, I took a deep breath. I knew my elderly parents were unable to house and nurse Greg for many months of surgical recuperation and supervised weight loss. But my husband and I have a house in Brooklyn. It even has a “granny flat” in the basement, with a separate bathroom and kitchenette. I’m a freelance writer, professionally mobile. Was I being called to put him up? But my brother was very difficult! Did I love him that much? Would my husband put up with him? Could I put up with him? Would Greg fit through our doorways? Would our little downstairs toilet crack under the strain? In times like these, even a committed atheist reaches for the metaphors of a Christian upbringing, and I thought, “Take this cup from me.”

As it happened, my brother’s condition abruptly plummeted again, and he died two days later. I never had to face down whether I was kind enough, loving enough, self-sacrificing enough, to take my brother on, to take my brother in. I got out of it.

Big Brother is not autobiographical. About a sister who risks her marriage by setting up housekeeping with a morbidly obese older brother to help him lose weight, the novel expressly describes what didn’t happen. Still, my brother’s loss was fresh. Like some of my previous novels, the issue of obesity combines the social with the profoundly private. Fat seemed like my material.

After all, I could appreciate that weight often interacts with a host of emotional troubles and other medical problems. Greg had never been heavy until two terrible accidents in quick succession – being beaten up with a metal baseball bat and broadsided on his moped by a car – left him in chronic pain, clinking with titanium, and barely able to walk. He could hardly keep off the pounds by jogging. Disability also curtailed his professional opportunities, which was disheartening, further inclining him to seek what gratification lay within reach (large jars of pickled sausages).

I may have been just over a hundred pounds but I did see how weight gain could snowball. As the brother, Edison, explains in the novel: “I used to look pretty good. Then I didn’t. That’s the point. Once I got sort of fat, one more baby-back rib didn’t matter. See, when you look sharp, you got something to protect – an investment to preserve, a power to keep. But when you’re already big, there’s nothing to lose from being bigger.” If you’re in good trim, it’s relatively easy to decline a cupcake: you’re motivated; you have a social resource to preserve. But for my brother, passing on a cupcake presented itself as pure self-denial with no commensurate reward. Once you’re hundreds of pounds overweight, eat it or don’t eat it, what difference does it make?

Most of all, I approached this subject with sympathy. I’d often been enraged on Greg’s behalf when we went somewhere together and all strangers seemed to see was some huge guy they hoped wouldn’t squeeze next to them on the bus. He was a remarkable person – the rebel of the family, the iconoclast. He dropped out of school at 14, and taught himself to be a sound engineer from books. He started his own company while still in his teens, building sound systems and recording studios. He was Philip Glass’s sound man for Einstein on the Beach in New York City, and toured with Harry Belafonte all over Europe. He’d tested as having a genius-level IQ (much to his siblings’ dismay), he was funny, he was politically clued-up, and his memorial service was crowded with devoted friends who revered him. Indeed, my biggest reservation about writing Big Brother was that I was loath for my own exceptional big brother to be remembered solely as fat.

. . .

I had anticipated this novel would be difficult because its origin made me sorrowful. I did not anticipate it would be hard for other reasons.

My biggest reservation was that I was loath for my exceptional big brother to be remembered solely as fat

So far, only a few other fiction writers have focused on fat. Yet over-eating has been relentlessly addressed in other media, especially television and glossy magazines. I didn’t want to publish dieting tips and slimming recipes, to write a thinly disguised self-help book, to rehash a clatter of conflicting scientific studies, or to go on the political warpath against fast food companies. A literary novel needed to dig down deeper: aside from nutrition, what do we get out of eating? Is food not more, as my narrator posits, “the idea of satisfaction, far more powerful than satisfaction itself”, a promise that never quite delivers? What is so alluring about food that some of us will imperil our very survival to consume too much of it? When we meet either the grossly fat or the skeletally thin, what do we assume about their characters? Considering the tentative connection we ourselves experience between who we are in our heads and what our bodies happen to look like, why do we continue to take appearance so seriously? What does it mean that the populations of whole countries in the west are getting so heavy? And, of course, any novel about obesity has to answer the question that paramedic raised in my parents’ living room: how does this happen?

The second section of Big Brother, in which Edison goes on an all-liquid diet, presented a headache if only in terms of entertainment. Weight loss is slow, and weight loss is dull – qualities no novelist courts. Lo, prose about losing weight can be every bit as tedious as the real thing. Yet I couldn’t simply have you turn a page and Edison’s long, gruelling diet is over. I needed the reader to share the sacrifice, determination, and daily application the diet required, but ideally without boring my poor reader senseless. Furthermore, every afternoon I worked on Part II, without fail, it made me hungry. I would no sooner have returned to Chapter Three in my study than I’d find myself back downstairs, staring soulfully into the refrigerator.

The other problem was structural. Any story about weight is linear – a shape no more sophisticated in literature than in geometry. I faced a range of obvious end points, none satisfying: a) Edison stays fat (static, not a story); b) Edison loses the weight and lives happily ever after (didn’t sound like a Shriver novel to me); c) Edison loses the weight only to gain it all back again. Now, the latter structure engenders an appealing pathos. Yet as a matter of principle I could not publish a novel with the implicit message that, in the long run, it’s impossible to lose weight and thus it’s pointless even to try.

So I chose d).

. . .

Would Greg have liked Big Brother? I hope so, though I imagine handing him a copy with apology. Wilful, brilliant, and entirely self-made, Greg Shriver was larger-than-life in a grander sense than girth. A proper “maverick” long before Sarah Palin co-opted the term, he was a bizarre hybrid of Southern good-old-boy and over-aged hippie, into his forties sporting rimless, yellow-tinted glasses, three waist-long dark pigtails, and a hard hat. I’ve met countless of his friends over the years who’ve said Greg was “the smartest guy they’d ever met”.

Working on the book made me hungry – I’d find myself staring soulfully into the refrigerator

He was a magnet for other compelling characters but also for bad luck, some of which he brought on himself, much of which simply arrived like a letter bomb. (In the mid-1990s, a small private plane freakishly crashed into Greg’s rental accommodation, demolishing that one house and nothing else. Fortunately Greg wasn’t home, but he lost everything he owned. His roommate only survived because he happened to be reaching for a beer, and the open door of the refrigerator shielded him from the blast. This stuff just doesn’t happen to normal people.)

Edison represents a mere sliver of the complicated, formidable older brother to whom the novel is dedicated, “in the face of whose drastic, fantastic, astonishing life any fiction pales”.

As for what readers might derive from the novel, I refer to my remarks at Greg’s memorial service: “It’s worth remembering that behind all that bloat and disability was an extraordinary person – a brother, a son, a father, a friend, and, yes, a genius – if only to remember that inside other distended and damaged bodies there are unusual people whom families and friends desperately love. That’s one thing I learnt from Greg during his latter life; I think he increased my compassion.” The optimal take-away from Big Brother in a word, then: compassion.

Because Greg didn’t regain consciousness, I never conducted that last conversation you miss so fiercely when loved ones die suddenly. As I told him in closing my memorial tribute, “If you’d only woken up, I’d have whispered in your ear that you were always the renegade, the outlaw, the real revolutionary in our family who had not only talent and brains but guts, and I was proud to be your sister.”